Amsacrine

For the Patient: Amsacrine

Other names: AMSA PD

Amsacrine (AM-sa-krin) is a drug that is used to treat some types of cancer. It is a

clear orange-red liquid that is injected into a vein.

Tell your doctor if you have ever had an unusual or allergic reaction to amsacrine
or acriflavine before receiving amsacrine.

A blood test may be taken before each treatment. The dose and timing of your
chemotherapy may be changed based on the test results and/or other side effects.

Other drugs may interact with amsacrine. Check with your doctor or pharmacist
before you start or stop taking any other drugs.

The drinking of alcohol (in small amounts) does not appear to affect the safety or
usefulness of amsacrine.

It is not known if amsacrine may damage sperm and may harm the baby if used
during pregnancy. It is best to use birth control while being treated with amsacrine.
Tell your doctor right away if you or your partner becomes pregnant. Do not breast
feed during treatment.

Tell doctors, dentists, and other health professionals that you are being treated with
amsacrine before you receive any treatment from them.

Side effects are listed in the following table in the order in which they may occur. Tips to
help manage the side effects are included.

SIDE EFFECTS MANAGEMENT

Amsacrine burns if it leaks under the skin.
Pain or tenderness may occur where the
needle was placed.
Tell your nurse or doctor immediately if
you feel burning, stinging, or any other
change while the drug is being given.
Apply cool compresses or soak in cool
water for 15-20 minutes several times a
day.

BC Cancer Agency Cancer Drug Manual Page 1 of 5 Amsacrine

Developed: September 1994
Revised: 1 September 2008

SIDE EFFECTS
Nausea and vomiting may occur after
your treatment and may last for several
hours. Most people have little or no
nausea.
Skin rashes may rarely occur.
Fever may rarely occur. Fever should last
no longer than 24 hours.
Your urine may be orange or reddish for
1-2 days after your treatment.
Diarrhea may sometimes occur.
Pain or swelling in the rectal area or
buttocks may rarely occur. Pain or swelling
may be accompanied by fever, a lump in
the rectal area, or painful bowel
movements.
BC Cancer Agency Cancer Drug Manual
Developed: September 1994
Revised: 1 September 2008
Amsacrine
MANAGEMENT
You may be given a prescription for
antinausea drug(s) to take before your
chemotherapy treatment and/or at home.
It is easier to prevent nausea than treat
it once it has occurred, so follow
directions closely.
Drink plenty of fluids.
Eat and drink often in small amounts.
Try the ideas in Food Choices to Help
Control Nausea.*
If rash is accompanied by signs of an
allergic reaction such as flushing,
dizziness, swelling, or breathing
problems, call your doctor immediately.
If itching is very irritating, call your
doctor. Otherwise, be sure to mention it
at your next visit.
Take acetaminophen (e.g., TYLENOL)
every 4-6 hours, to a maximum of 4 g
(4000 mg) per day.
If you have fever (over 100F or 38C by
an oral thermometer) plus another sign
of infection, call your doctor
immediately. Other signs of infection
include chills, cough, or burning when
you pass urine.
This is expected as amsacrine is orange-
red coloured and is passed in your urine.
If you notice blood in your urine, call
your doctor immediately.
If diarrhea is a problem:
Drink plenty of fluids.
Eat and drink often in small amounts.
Avoid high fibre foods as outlined in
Food Ideas to Help with Diarrhea During
Chemotherapy.*
Report this to your doctor immediately.
Page 2 of 5 Amsacrine

SIDE EFFECTS
Your white blood cells may decrease 11-
13 days after your treatment. They usually
return to normal 17-25 days after your last
treatment. White blood cells protect your
body by fighting bacteria (germs) that
cause infection. When they are low, you
are at greater risk of having an
infection.
Your platelets may decrease 12-14 days
after your treatment. They usually return
to normal 21-25 days after your last
treatment. Platelets help to make your
blood clot when you hurt yourself. You
may bruise or bleed more easily than
usual.
Sore mouth may sometimes occur a few
days after treatment. Mouth sores can
occur on the tongue, the sides of the
mouth, or in the throat. Mouth sores or
bleeding gums can lead to an infection.
Loss of appetite and weight loss are
common and may persist after
discontinuation of amsacrine.
BC Cancer Agency Cancer Drug Manual
Developed: September 1994
Revised: 1 September 2008
Amsacrine
MANAGEMENT
To help prevent infection:
Wash your hands often and always after
using the bathroom.
Avoid crowds and people who are sick.
Call your doctor immediately at the first
sign of an infection such as fever (over
100F or 38C by an oral thermometer),
chills, cough, or burning when you pass
urine.
To help prevent bleeding problems:
Try not to bruise, cut, or burn yourself.
Clean your nose by blowing gently. Do
not pick your nose.
Avoid constipation.
Brush your teeth gently with a soft
toothbrush as your gums may bleed
more easily. Maintain good oral
hygiene.
Some medications such as ASA (e.g.,
ASPIRIN) or ibuprofen (e.g., ADVIL)
may increase your risk of bleeding.
Do not stop taking any medication that
has been prescribed by your doctor
(e.g., ASA for your heart).
For minor pain, try acetaminophen (e.g.,
TYLENOL) first, to a maximum of 4 g
(4000 mg) per day, but occasional use
of ibuprofen may be acceptable.
Brush your teeth gently after eating and
at bedtime with a very soft toothbrush. If
your gums bleed, use gauze instead of a
brush. Use baking soda instead of
toothpaste.
Make a mouthwash with teaspoon
baking soda or salt in 1 cup warm water
and rinse several times a day.
Try the ideas in Food Ideas for a Sore
Mouth During Chemotherapy.*
Try the ideas in Food Ideas to Help with
Decreased Appetite.*
Page 3 of 5 Amsacrine
 Amsacrine

SIDE EFFECTS MANAGEMENT

Tiredness and lack of energy may
sometimes occur.
Hair loss is common and may begin
within a few days or weeks of treatment.
Your hair may thin or you may lose it
completely. Your scalp may feel tender.
Hair loss may occur on your face and
body. Hair will grow back once your
treatments are over and sometimes
between treatments. Colour and texture
may change.
*Please ask your chemotherapy nurse or pharmacist for a copy.
Do not drive a car or operate machinery
if you are feeling tired.
Try the ideas in Your Bank to Energy
Savings: How People with Cancer Can
Handle Fatigue.*
Refer to For the Patient: Hair loss due to
chemotherapy.* You may also want to:
Apply mineral oil to your scalp to reduce
itching.
If you lose your eyelashes and
eyebrows, protect your eyes from dust
and grit with a broad-rimmed hat and
glasses.

SEE YOUR DOCTOR OR GET EMERGENCY HELP IMMEDIATELY IF YOU HAVE:

Signs of an infection such as fever (over 100F or 38C by an oral thermometer),
shaking chills; severe sore throat, productive cough (coughing up thick or green
sputum); cloudy or foul smelling urine; painful, tender, or swollen red skin wounds or
sores.
Signs of bleeding problems such as black, tarry stools; blood in urine; pinpoint red
spots on skin; extensive bruising.
Pain or swelling in the rectal area or buttocks.
Signs of an allergic reaction (rare) soon after a treatment including dizziness, fast
heart beat, face swelling, or breathing problems.
Signs of heart or lung problems such as fast or uneven heartbeat, chest pain,
chest pressure, shortness of breath or difficulty in breathing, swelling of feet or lower
legs, or fainting.
Seizures or loss of consciousness.

SEE YOUR DOCTOR AS SOON AS POSSIBLE (DURING OFFICE HOURS) IF YOU

HAVE:
Signs of anemia such as unusual tiredness or weakness.
Signs of liver problems such as yellow eyes or skin, white or clay-coloured stools.
Signs of kidney problems such as lower back or side pain, swelling of feet or lower
legs.
Numbness or tingling in feet or hands.
Signs of gout such as joint pain.
Changes in eyesight.
Increased sore throat or mouth that makes it difficult to swallow comfortably.

BC Cancer Agency Cancer Drug Manual Page 4 of 5 Amsacrine

Developed: September 1994
Revised: 1 September 2008
 Amsacrine

CHECK WITH YOUR DOCTOR IF ANY OF THE FOLLOWING CONTINUE OR

BOTHER YOU:
Uncontrolled nausea, vomiting, diarrhea, or weight gain or loss.
Headache or pain not controlled with acetaminophen (e.g., TYLENOL).
Easy bruising or minor bleeding.
Redness, swelling, pain, or sores where the needle was placed.
Redness, swelling, pain, or sores on your lips, tongue, mouth, or throat.
Skin rash or itching.
Confusion or mood changes that are not usual for you.
Dizziness.

REPORT ADDITIONAL PROBLEMS TO YOUR DOCTOR

BC Cancer Agency Cancer Drug Manual Page 5 of 5 Amsacrine

Developed: September 1994
Revised: 1 September 2008